Tips for training with Chronic Fatigue (CFS)?

General Discussion
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(Sorry for a long post - posting this both to ask some questions, and to clear my mind a bit.)

Back in 2010 I was a healthy 40 year old active Masters cyclist who finished several ultra races up to 540 km. I was never very fast but I had pretty decent endurance. I was active in a local club and all my friends were cyclists. My life was all about cycling.

Then I got ill with Interstitial Cystitis (Bladder Pain Syndrome) and in 2013 I had to stop cycling due to pain and other complications. It was the start of a long and difficult journey which ended with surgery in December 2018 when they took out my bladder and made a subsitute from 54cm of ileal gut.

Since the surgery I have struggled to come back to regular exercise. Whenever I take up training I end up having to abandon it due to various causes like muscle pain, lower back issues, extreme tiredness etc.

After many visits to the doctor I am now being checked for Chronic Fatigue Syndrome and Autonomous Dysfuction.

I turned 50 in November and this winter I am trying to start from scratch at 140W FTP. I am at the end of week 4 of the 6 wk beginner FTP training program. This is a 6 week program of 50-70 minute workouts aimed to increase FTP.

But I am really struggling hard with fatigue issues. Some days workouts go well, other days I am struggling through the entire workout and just want to stop it. I still have a bit of HTFU mentality left in me so I try to endure, although I do skip some intervals now and then. I sometimes try to up the Bias til 110% but that usually turns out to be too much. I’m having a hard enough time just managing to pedal at 90-100 strokes around 110W…and if I try to raise my FTP it becomes too hard for me.

I don’t really worry about the FTP in itself since it’s just a number.

However, the problem is that it seems that even this exercise is too much for me. Some days I simply don’t function after the workout and it’s a struggle just to sit upright on the sofa and watch TV. Eventually I might and up lying on my bed just to avoid sitting up. I feel powerless. I also get some post-exercise pain (one night I woke up with severe pain in both thighs and could not get rid of it).

I find that these past 4 weeks have been good in the sense that I feel more active and the regular exercise lighten up my days (especially with Covid-19 forcing us to stay home most of the time).

But I need help with finding out how to exercise.

I don’t know what to do. Maybe I should focus on shorter workouts. I could try to do just 30 minute workouts for a while. In my experience spinning exercises shorter than about 50 minutes are not really helpful. But it’s better than nothing…

Is there anyone here with similar issues or experiences? I really need some advice.

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My short answer is back off the intensity.
Your past may be haunting you.
You know your not the same.
Your physically not the same but there’s a part of you that wants to push and your still comparing yourself and your efforts to some modified version of previous you.

Really, start over and go slow and stay well within your envelope.
If you are dealing with chronic fatigue, you can’t work thru it but you can improve but you must avoid doing too much.
The hard part is, you don’t know how close to the limit you are until the day after you have exceeded it.
You might start with a beginner work out, day 1 and repeat that for 1-2 weeks and see how you feel.
Remember, you get physical feed back the day after.

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Thanks, Tim. I know that you are right of course. I will investigate easier programs. I seriously considered this a «beginner» program though (since it says so in the title of the program). :slight_smile:

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Hey Tormod,
If you find a strategy that works for you, please post an up date.
I’ve spoken to others with similar issues and no 1 strategy works for all but sometimes explaining what worked for others, helps people find their solution.

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It’s a beginner’s program for people without chronic health conditions. In your case, you are not a typical beginner.

Listen to what your body is telling you, and remind your brain that things have changed when it tries to tell you to HTFU. It might be hard to accept, but only by understanding your limitations can you then work on moving forwards.

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Hi @tormodg,

Although I am not struggling with chronic fatigue, I did recently complete the Beginner FTP Builder and wanted to share a bit of my experience. I am 54 and started with Zwift’s training programs last fall. I started Zwifting in 2018 and was riding a couple of times a week in addition to going to the gym and doing a modified Body for Life type schedule 5 days a week. Then in 2019 my husband’s company transferred him to Houston, so I had to pack up the trainer (it was in the front hallway and the realtor suggested that was a bad idea), quit the gym etc. With the stress of the move, the new location, and “being a woman of a certain age” (peri-menopausal with things like insomnia and hormone fluctuations) I lost the fitness I had and then have had a heck of a time getting back into training. I had joined a gym at the beginning of 2020, but that didn’t feel safe once the pandemic hit. So the training programs in Zwift have been wonderful for me. I had ridden around the worlds some (2 or 3 times a week for maybe five months?) and then decided to try a training plan at the end of the summer and into the fall.

When I started the training, I did do an FTP test. Zwift had me at 118, down from the 134 that I had had without any extra effort 2 years ago when I was still going to the gym regularly. When I did the FTP test, it put me at 112. I decided maybe I had panicked during the test and set myself back to 118 manually. How did you determine your FTP? I do wonder whether FTP is the best number to use when you are coming back from illness and surgery. My 2 cents on setting the FTP is to be really careful about that. I have now done the FTP Builder twice and am in week 3 of Build Me Up. Early on in Build Me Up I went on one of the Tour de Zwift Rides and had a really good day. Plenty of sleep, the correct fueling (ate enough good food beforehand) and was super excited to be in a group of women, so I had an unusually good ride and got a message that my FTP had increased. Well, when I did the next workout, it was really, really awful. I felt utterly exhausted and had to pause several times and dial the difficulty back as far as the app would allow. I went right in after that and lowered my FTP to what it had been. Much better. I want my workouts to feel doable.

You also mention the cadence and I would think that the high cadence drills could be problematic for abdominal surgery recovery. I have noticed when I attempt them that I really need to work more on my core strength and what I think is my hip/pelvic muscle strength.

Since you mention back pain, it also made me think about my struggles to get my bike setup right. I have one leg that is a good bit longer than the other. Many people don’t believe me, but you can clearly see that the side with the shorter leg also has a noticeably smaller foot, so anyway I have determined that my leg length coupled with a really significant forefoot tilt can have an effect all the way up into my hips and back. Which is another way of saying that the body is all connected and maybe there is something going on to cause the muscle pain that has directly to do with the workouts and your new post-surgery body-on-bike position. Did that make sense?

IMO some of the workouts in the beginner program are really, really hard. There were some that I definitely was not able to complete well. I used the companion app to reduce the intensity on some and I hit the “pause” button to give myself longer breaks when it got too intense. I monitor my heart rate and when it ended up to high for too long, that was another clue that the higher FTP was hurting and not helping.

Here is a link to one of the podcasts from the Trainer Road folks. I thought the whole thing was really helpful. It’s long, but if you have time, there is a lot of good info throughout. Underneath the video, they have time stamps with general titles for the content if you want to skip stuff (like a whole section on mountain biking). In particular, I found the parts helpful about recovery as an older cyclist (17:22) and about comparing ourselves to others and getting back into cycling after a longer break (1:58). https://www.youtube.com/watch?v=PZdcyRPsL0Y&t=7183s

I’m sorry this has gotten so long. I hope you can find something helpful here and wish you all the best during your recovery and beyond! Hope to see you out there.

Ride On,
Beth

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Thank you, Beth. That was an insightful response. Thank you for sharing your own experience.

How did I come up with my FTP? Last winter I started attending my cycling club’s indoor training. I started with a far too high FTP and after getting some advice set it at 140. Three months later it was at 180. Then Corona hit and organized training was no longer an option.

So I simply started over at the same point. This time however it seems to be too high, like you are suggesting. I guess it’s time to try the FTP test and see how far I get.

I will try to take a few steps back. I think that right now, regular easy exercise is much better than exhausting efforts, and definitely better than no exercise at all.

The idea that abdominal surgery may be an issue has not occured to me before you mentioned it. Thanks for suggesting that.

Edit: I should add that my situation has gotten worse during the past year, so I need to rethink my initial approach.

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